Nocturnal blood pressure and silent cerebrovascular lesions in elderly Japanese

We conducted a cross-sectional epidemiological survey using ambulatory blood pressure monitoring and brain MRI in a cohort from northern Japan to determine whether an inappropriately low nocturnal blood pressure, or an excess fall in nocturnal blood pressure, might be responsible for silent cerebrov...

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Bibliographic Details
Published in:Stroke (1970) 1996-08, Vol.27 (8), p.1319-1327
Main Authors: WATANABE, N, IMAI, Y, ABE, F, HISAMICHI, S, ABE, K, NAGAI, K, TSUJI, I, SATOH, H, SAKUMA, M, SAKUMA, H, KATO, J, ONODERA-KIKUCHI, N, YAMADA, M
Format: Article
Language:English
Subjects:
Age Distribution
Aged
Biological and medical sciences
Blood Pressure - physiology
Brain Ischemia - diagnosis
Brain Ischemia - epidemiology
Brain Ischemia - physiopathology
Cerebral Infarction - diagnosis
Cerebral Infarction - epidemiology
Cerebral Infarction - physiopathology
Cerebrovascular Disorders - diagnosis
Cerebrovascular Disorders - epidemiology
Cerebrovascular Disorders - physiopathology
Circadian Rhythm - physiology
Cohort Studies
Cross-Sectional Studies
Female
Humans
Hypertension - complications
Hypertension - epidemiology
Japan - epidemiology
Magnetic Resonance Imaging
Male
Medical sciences
Middle Aged
Neurology
Vascular diseases and vascular malformations of the nervous system
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Summary:We conducted a cross-sectional epidemiological survey using ambulatory blood pressure monitoring and brain MRI in a cohort from northern Japan to determine whether an inappropriately low nocturnal blood pressure, or an excess fall in nocturnal blood pressure, might be responsible for silent cerebrovascular lesions in the elderly. Untreated subjects over 55 years and under 64 years of age (late middle age; 24 men and 46 women, 60% of eligible people) and over 65 years and under 75 years of age (elderly; 29 men and 52 women, 91% of eligible people) participated in the study. We evaluated the relationship between the amplitude (Daytime Average-Nighttime Average) or the rate ([Daytime Average-Nighttime Average]/Daytime Average) of the fall in nocturnal blood pressure and the incidence of silent cerebrovascular lesions on MRI (number of lacunar infarctions or extent of periventricular hyperintensity). The amplitude or the rate of the fall in nocturnal blood pressure in elderly women with one or two lacunar infarctions was significantly higher than that in those without such infarctions. There was a significant positive correlation between the amplitude or the rate of the fall in nocturnal blood pressure and the extent of periventricular hyperintensity in the elderly women. This relationship was observed in women, but not in men, of late middle age; this was not seen in elderly men. Results indicate that an inappropriately low nocturnal blood pressure, or an excessive fall in nocturnal blood pressure, is associated with ischemic silent cerebrovascular lesions, at least in elderly women. Treatment of hypertension in such women should be administered with care and with regard to nocturnal blood pressure.
ISSN:0039-2499
1524-4628
DOI:10.1161/01.str.27.8.1319